OC 15-04CERVICAL CANCER SCREENING IN THE NETHERLANDS: DETERMINATION OF HPV PREVALENCE USING THREE DIFFERENT SYSTEMS

10. HPV testing
C.J. Huijsmans 1, W.R. Geurts-Giele 2, C. Leeijen 1, E. Hazenberg 1, J. Van Beek 3, J.C. Van Der Linden 1, A.J. Van Den Brule 1.
1Pathologie-DNA, location Jeroen Bosch Hospital, ’s-Hertogenbosch (Netherlands), 2Pathologie-DNA, location Jeroen Bosch Hospital, ’s-Hertogenbosch and Erasmus MC Cancer Institute, Department of Pathology, Rotterdam (Netherlands), 3Pathologie-DNA, location Rijnstate Hospital, Arnhem (Netherlands)

Background / Objectives

Primary high risk (hr)HPV screening will be introduced in The Netherlands during the 1st quarter of 2017. Our aim was to determine the hrHPV prevalence in a cohort of women representative for the Dutch population based screening program.


Methods

A total of 11,802 residual PreservCyt cervical samples from the Dutch population based cytology screening program were rendered anonymous, randomized and tested for hrHPV using 3 completely automated HPV detection systems: Qiagen Hybrid Capture 2 (HC2, signal amplification), Roche Cobas® 4800 (DNA amplification) and Hologic Aptima (RNA amplification). To determine the agreement between results generated using the different assays, pair wise comparison of the systems was performed by determining kappa coefficients.


Results

The selected samples were representative for the population based screening program with respect to age distribution and cytology classification. HrHPV prevalences found were: 8.1% for HC2, 8.0% for Cobas® 4800 and 7.6% for Aptima, resulting in a mean hrHPV prevalence of 7.9±0.3%. Therefore, independently of the assay used, the hrHPV prevalence is significantly higher than the previously reported 4-5% using the GP5+/6+PCR-EIA (POBASCAM) and HC2 (VUSA-Screen) hrHPV tests. As expected, a clear age dependency was found, with an hrHPV prevalence ranging from 18.6±1.1% in women 29-33 years of age to 3.9±0.3% in women 59-63 years of age. Also for severity of cytology a correlation with hrHPV prevalence was observed, ranging from 5.4±0.3% in normal cytology to 92.2±3.1% in severe dysplasia. Kappa coefficients of 0.77, 0.71 and 0.72 (HC2 vs Cobas® 4800, Cobas® 4800 vs Aptima and Aptima vs HC2, respectively) indicated substantial agreement between the results generated.


Conclusion

In contrast to the report of the Dutch Health Council, a higher hrHPV prevalence of 7.9±0.3% was found in this population based screening cohort using the complete hrHPV detection systems from Qiagen HC2, Roche Cobas® 4800, and Hologic Aptima, which has consequences for the cost-effectiveness of the Dutch screening program. Additionally, based on the kappa coefficients, agreement of results between the 3 hrHPV testing solutions was substantial.


References